Individual
MRS. STACY NICOLE ALVARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
100-A LINDSEY LANE, KINGSLAND, GA 31548
(912) 729-1333
(912) 729-5259
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 802-1991
(706) 802-1408
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002436
GA
225200000X
Physical Therapy Assistant
PTA16364
FL
225700000X
Massage Therapist
MA 53221
FL
225700000X
Massage Therapist
MT 006802
GA
Other
Enumeration date
12/30/2008
Last updated
12/02/2010
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